Creator(s)

Document Type

Article

Publication Date

4-1-2016

Identifier

DOI: 10.1542/peds.2015-3100

Abstract

BACKGROUND: Urgent care (UC) is one of the fastest growing venues of health care delivery. We compared clinical and cost attributes of pediatric UC and emergency department (ED) visits that did not result in admission.

METHODS: Our study examined 5 925 568 ED and UC visits of children under 19 years old in the 2010 through 2012 Marketscan Medicaid Multi-State Database. Basic demographics, diagnoses, severity, and payments were compared. Between ED and UC visits, χ(2) tests were used for proportions and Wilcoxon rank-sum tests were used for continuous variables.

RESULTS: The UC and ED had the same most common diagnoses. Over half the UC visits were low severity. The ED had a higher rate of return within 7 days (8.4% vs 6.9%, P < .001) and follow-up with their primary care physician (22% vs 17.2%, P < .001). Few (

CONCLUSIONS: UC and ED Medicaid visits have similar most common diagnoses, rate of return, and admission. Severity level and payments were lower in UC. There is potential significant cost savings if lower acuity cases can be transitioned from the ED to UC.

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Children's Mercy, located in Kansas City, Mo., is one of the nation's top pediatric medical centers. The not-for-profit hospital provides care for children from birth through the age of 21, and is ranked by U.S. News & World Report as one of "America's Best Children's Hospitals.“
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